Many opponents of giving equal rights and protections to gay Americans — at the workplace, in the military, in marrying and forming families — make the claim that homosexuality is a chosen way of life. They have long seized on the work of a towering figure in psychiatry to justify their position.
But that psychiatrist, Dr. Robert Spitzer, has now renounced a study [ http://www.truthwinsout.org/news/2012/04/24542/ (Spitzer's letter from that source below)] he did a decade ago that suggested that “reparative therapy” can help homosexuals who are highly motivated to change their sexual orientation. Dr. Spitzer’s admission that his study was deeply flawed should discredit, once and for all, those claims of social and religious conservatives that homosexuality is not a fundamental part of human identity.
Dr. Spitzer’s turnabout was described by Benedict Carey in The Times on Saturday [ http://www.nytimes.com/2012/05/19/health/dr-robert-l-spitzer-noted-psychiatrist-apologizes-for-study-on-gay-cure.html (the post to which this is a reply)]. Dr. Spitzer’s enormous influence came from the fact that he directed a rigorous rewriting of the psychiatry profession’s diagnostic manual of mental disorders. Even before that, he successfully pressed to drop homosexuality from the manual.
Two decades later, still eager to challenge accepted wisdom, he conducted an in-depth telephone survey of 200 gay men and women who had received therapy or pastoral counseling to change their sexual behavior. Most told him that they had changed from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation.
Now Dr. Spitzer, who just turned 80, has acknowledged that his survey was deeply flawed. In a letter to the editor of the Archives of Sexual Behavior, which had published his study, he said he had no way of knowing whether the patients who said they had changed were deceiving themselves, lying or reporting accurately. He apologized for making “unproven claims” about reparative therapy and for any harm he may have caused to anyone who “wasted time and energy” undergoing the therapy.
Critics have noted that the people interviewed were nominated by centers that were performing the therapy and that there was no control group and no clear definition of what counted as therapy. There is also some evidence that reparative therapy can lead to depression or suicidal thoughts and behavior. It is absurd, potentially harmful, pseudopsychiatry. It should have been rejected long ago.
Several months ago I told you that because of my revised view of my 2001 study of reparative therapy changing sexual orientation, I was considering writing something that would acknowledge that I now judged the major critiques of the study as largely correct. After discussing my revised view of the study with Gabriel Arana, a reporter for American Prospect, and with Malcolm Ritter, an Associated Press science writer, I decided that I had to make public my current thinking about the study. Here it is.
Basic Research Question. From the beginning it was: “can some version of reparative therapy enable individuals to change their sexual orientation from homosexual to heterosexual?” Realizing that the study design made it impossible to answer this question, I suggested that the study could be viewed as answering the question, “how do individuals undergoing reparative therapy describe changes in sexual orientation?” – a not very interesting question.
The Fatal Flaw in the Study – There was no way to judge the credibility of subject reports of change in sexual orientation. I offered several (unconvincing) reasons why it was reasonable to assume that the subject’s reports of change were credible and not self-deception or outright lying. But the simple fact is that there was no way to determine if the subject’s accounts of change were valid.
I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy. I also apologize to any gay person who wasted time and energy undergoing some form of reparative therapy because they believed that I had proven that reparative therapy works with some “highly motivated” individuals.
Robert Spitzer. M.D. Emeritus Professor of Psychiatry, Columbia University
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